Participation in Health Management Using Patient Portals: Opportunities for OT Practice With the Older Adult Population

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510223p1-7512510223p1
Author(s):  
An T. Nguyen ◽  
Pamela S. Roberts
Keyword(s):  
Older Adult ◽  
Health Management ◽  
Adult Population ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Patient Portal ◽  
Patient Portals ◽  
Cross Sectional ◽  
Health Technologies ◽  
Older Adult Population

Abstract Date Presented 04/7/21 Participants will identify patient characteristics associated with decreased participation in health management using electronic health technologies, particularly patient portals. Results of a cross-sectional study of patient portal adoption among 154,189 patients at a large, urban U.S. health care system will be presented. Implications for OT practice with the older adult population will be emphasized and proposed as a prime area of opportunity. Primary Author and Speaker: An T. Nguyen Additional Authors and Speakers: Breanna Carter, Molly Cutler

scholarly journals Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

2019 ◽  
Author(s):  
Kristine Thorell ◽  
Patrik Midlöv ◽  
Johan Fastbom ◽  
Anders Halling
Keyword(s):  
Older Adult ◽  
Chronic Conditions ◽  
Adult Population ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Older Adult Population ◽  
Inappropriate Medications

Abstract Background: Potential inappropriate medications (PIM) have an increased risk for adverse drug reactions (ADR) in an older adult population. With increasing age, multimorbidity is growing along with the use of medications. For several years, polypharmacy has been found to increase in western societies. Polypharmacy is associated with an increased risk of ADR. In this study, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1) or on the 31st December 2013 (cohort 2) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value 0.000) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value 0.000). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80 to ≤ 85 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013. Polypharmacy does not increase significantly compared to the rest of the population.

scholarly journals Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study (Preprint)

2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea
Keyword(s):  
Patient Characteristics ◽  
Survey Study ◽  
Patient Portal ◽  
Older Individuals ◽  
Patient Portals ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Multiple Variable ◽  
Nationally Representative ◽  
National Trends

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

scholarly journals Characteristics and Circumstances of Falls in the Community-Dwelling Older Adult Population

2020 ◽  
Vol 11 ◽  
pp. 215013272094050 ◽  
Author(s):  
María Pilar Molés Julio ◽  
Ana Lavedán Santamaría ◽  
Teresa Botigué Satorra ◽  
Olga Masot Ariño ◽  
Aurora Esteve Clavero ◽  
...  
Keyword(s):  
Health Care ◽  
Older Adult ◽  
Statistical Significance ◽  
Adult Population ◽  
Community Dwelling ◽  
Survey Study ◽  
Single Family ◽  
Cross Sectional ◽  
Randomized Sampling ◽  
Older Adult Population

Objective: The study aimed to describe the characteristics and circumstances of falls in the community-dwelling older adult population. Design: This was a cross-sectional observational and descriptive study involving primary health care centers in Lleida and Castellón de la Plana, Spain. Randomized sampling was used to include 966 individuals aged 75 years or older residing in single-family homes and in possession of a health care card. Data were obtained using the Survey on Fragility in Older People in Lleida (FRALLE survey). Study variables included the occurrence of falls in the past year and fall characteristics such as whether it was a first or successive fall, cause, season, and time of the day the fall occurred, whether the respondent fell flat on the ground, and time the participant remained on the floor. Other variables involved the circumstances of the fall, including the general location of the fall and specific location within the home if applicable, lighting/weather conditions, objects which may have precipitated the fall, floor conditions, and type of footwear. Results: The prevalence of falls was 25.9% with regard to the previous year, with 70% of these participants reporting having fallen previously. Falls most often occurred by accident, during the daytime, and in the winter. Variables that showed statistical significance with regard to age group were: falling flat on the ground ( P = .031), fall location ( P = .000), presence of an object favoring the fall ( P = .039), floor conditions ( P = .011), and type of footwear ( P = .029). By sex, variables that showed statistical significance included the need for assistance to get up ( P = .045) and type of footwear ( P = .028). Conclusions: The prevalence of falls was found to be similar in the studied cities. The results show the most common characteristics and circumstances of falls in older adults in the community, making it possible to guide future preventive strategies.

scholarly journals Multimorbidity patterns and their relationship to mortality in the US older adult population

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245053
Author(s):  
D. Diane Zheng ◽  
David A. Loewenstein ◽  
Sharon L. Christ ◽  
Daniel J. Feaster ◽  
Byron L. Lam ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Chronic Conditions ◽  
Latent Class ◽  
Adult Population ◽  
Cognitively Impaired ◽  
Cross Sectional ◽  
Respiratory Condition ◽  
The Us ◽  
Older Adult Population

Background Understanding patterns of multimorbidity in the US older adult population and their relationship with mortality is important for reducing healthcare utilization and improving health. Previous investigations measured multimorbidity as counts of conditions rather than specific combination of conditions. Methods This cross-sectional study with longitudinal mortality follow-up employed latent class analysis (LCA) to develop clinically meaningful subgroups of participants aged 50 and older with different combinations of 13 chronic conditions from the National Health Interview Survey 2002–2014. Mortality linkage with National Death Index was performed through December 2015 for 166,126 participants. Survival analyses were conducted to assess the relationships between LCA classes and all-cause mortality and cause specific mortalities. Results LCA identified five multimorbidity groups with primary characteristics: “healthy” (51.5%), “age-associated chronic conditions” (33.6%), “respiratory conditions” (7.3%), “cognitively impaired” (4.3%) and “complex cardiometabolic” (3.2%). Covariate-adjusted survival analysis indicated “complex cardiometabolic” class had the highest mortality with a Hazard Ratio (HR) of 5.30, 99.5% CI [4.52, 6.22]; followed by “cognitively impaired” class (3.34 [2.93, 3.81]); “respiratory condition” class (2.14 [1.87, 2.46]); and “age-associated chronic conditions” class (1.81 [1.66, 1.98]). Patterns of multimorbidity classes were strongly associated with the primary underlying cause of death. The “cognitively impaired” class reported similar number of conditions compared to the “respiratory condition” class but had significantly higher mortality (3.8 vs 3.7 conditions, HR = 1.56 [1.32, 1.85]). Conclusion We demonstrated that LCA method is effective in classifying clinically meaningful multimorbidity subgroup. Specific combinations of conditions including cognitive impairment and depressive symptoms have a substantial detrimental impact on the mortality of older adults. The numbers of chronic conditions experienced by older adults is not always proportional to mortality risk. Our findings provide valuable information for identifying high risk older adults with multimorbidity to facilitate early intervention to treat chronic conditions and reduce mortality.

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